Proposed Topic (Most preferred): :
Clinical Safety and Quality Service II (Projects aiming to enhance clinical safety and outcomes, clinical governance / risk management)
Authors (including presenting author) :
Cheung TH (1)(2), Chan KH (1)(2), Tong HK (1)(2), Wong YCJ (1)(2)
Affiliation :
(1) Caritas Medical Centre (2) Department of Operating Theatre
Introduction :
Surgical plume (also known as surgical smoke, cautery smoke, smoke-plume, diathermy plume) is a by-product produced by the electrosurgical instruments (diathermy, LASER, ultrasonic device, high speed drills, burs and saws) used to dissect tissue, provide haemostasis and perform LASER ablation. It consists of 95% water but 5% of dead and live cellular material (blood fragments, bacteria, viruses), toxic gases, vapors (e.g. benzene, hydrogen cyanide, formaldehyde) and VOCs (Volatile Organic Compounds). These would bring hazardous effect on the health of the whole surgical team as well as the patients themselves. The health risks associated with surgical plume including Increase the risk of acute and chronic pulmonary disease, cause acute headaches, Irritation and soreness of the eyes, nose and throat, dermatitis, transmission of both bacterial and viral infectious disease and bring carcinogenic and mutagenic effects. Therefore, there is an urge need to remove surgical plume or at least decrease its level within the operating theatre for the sake of the surgical team. In this project, we are trying to find out solution for surgical plume and enhance occupational safety in the theatre.
Objectives :
1. To reduce the level of surgical plume in operating theatre by seizing an
appropriate intervention tool with EBP model
2. To measure the effectiveness/ significance of the intervention tool
3. To navigate the surgical team for the change of practice
Methodology :
1. By applying the Johns Hopkins Evidence-based practice model, smoke
evacuation diathermy was selected as the intervention tool
2. Total knee replacement and open spinal surgery were chosen for trial run of the
smoke evacuation diathermy for their extensive use of diathermy.
3. Control and intervention group was set up to illustrate the effectiveness of the
intervention tool by measuring the air quality within the operating theatre.
Result & Outcome :
Quantitative result demonstrated smoke evacuation diathermy successfully remove surgical plume and significantly improve the air quality inside the theatre.
Qualitative result revealed the whole surgical team (surgeon, anesthetist, theatre nurse and other operating theatre personnel were happy to embrace the change as the bad smell and smoke produced by ordinary diathermy previously was prohibited. This was good for their health and therefore occupational safety was also enhanced.
